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ARRT BOARD Radiation safety

Terms in this set (43)

Discuss what is meant by ALARA
-ALARA Stands for as low as reasonably achievable

-it is aimed at reducing radiation exposure and individuals who work routinely with radiation
Define the three units of measurement for radiation exposure
Roentgen (R)
radiation absorbed dose (RAD)
radiation equivalent man (REM)
Defined the 3 units of measure for radiation exposure
-Roentgen is a term applied to x-rays and gamma rays it is the amount of radiation it takes to produce one electrostatic charge in 1 cc of dry air at standard temperature and pressure

-RAD Encompasses all types of radiation not just x-rays and gamma rays

-REM Is the unit of measure apply to radiation exposure in humans
Explain how personal monitoring devices should be worn
-All film badges should be worn in the area of the body at risk of greatest radiation exposure usually the chest or collar area
- individuals who wear devices on fingers such as nuclear med techs should not have the device facing away from the palm
-finger badges should be worn so they are facing the radioactive material while injection is being performed
What type of event is reportable to the NRC
-I 131 to the wrong patient

-administer doses that exceed 20% of the total prescribe dose
- single therapeutic dose
that varies by more than 20% from the written directive or a weekly therapeutic dose to varies by more than 30% from the written directive
Discussed the methods for determining if an area is contaminated
-An area survey should be performed daily to check for radio active contamination in areas were radiopharmaceuticals are assayed, prepared, and administered
-an area survey should be performed on a weekly basis in all areas where radiopharmaceuticals are stored and where radioactive waste is placed for decay
-A wipe test should be performed on a weekly basis in all areas were radioactive materials are prepared administered or stored
Explain the proper methods for disposal of radioactive waste
Radioactive patient urine and feces can be legally disposed of by releasing them into the sewer
-Store waist until radiation levels decayed background level then dispose of the waste in the regular trash or biohazard trash
-waste can be transferred to an authorized recipients for disposal. when this method is selected the waste must be in proper container with the proper shipping labels in order to transport it legally
Explain the process for decontamination of a radioactive spill
The person who caused the spill is typically responsible for cleaning up the spill
- first assess the spell for amount of radiation, type of isotope, and the extent of contamination
-second the spill should be contained to prevent contamination of other areas
-third contaminated area should be made off-limits to all people not involved with the decontamination procedures.
-contaminated areas should be clearly marked by signs are other easily noticed warnings
-decontamination efforts should continue until the wipe test of the area is below 200 DPM/CM2
Defined the classifications of a contaminated area
-Contaminated areas are classified by the type of area being surveyed in the type of isotope area is contaminated with restricted areas are areas such as hot labs and stress testing areas were radioactive materials are prepared and administered
-a restricted area is considered to be contaminated if a wipe test delivers a result greater than 20, 000 DPM/ cm2 for isotope such as tech or thallium
-threshold for a restricted area is lower than 2,000 DPM/ 100 cm2 if the area is contaminated with a high energy isotopes such as I 131 or Indium 111
Define and discussed the MIPPA law
Is a piece of 2008 legislation that requires all non-hospital centers of advanced diagnostic imaging to obtain accreditation from in American College of radiology or the inter-social commissions for the accreditation of nuclear medicine laboratories by January 2012
Discuss proper method of storage for sealed Radioactive sources
-They should be stored in a very specific manner
-each sealed source should have its own individual container so it cannot become lost and to make inventory easier
-they should be inventoried at least quarterly during a formal audit of the nuclear medicine facility
- if any new sealed sources are required between audits the new sources should be added to the inventory upon receipt
Discussed the ACR and it's significance for nuclear medicine facilities
-The American College of radiology is in accrediting body that imposes standards for nuclear cardiology nuclear medicine and pet facilities and all other imaging modalities such as CT and MRI
-ACR standards must be met to obtain accreditation
-many insurances reimbursements are based on procedures being performed at accredited facilities
Discuss the parameters in which radioactive waste may be decayed in storage
-Radioactive waste can legally be decayed in storage if the isotopes contained in the waste have a physical half-life of less than 65 days
-radioactive waste must be held in storage for no less than 10 half-lives and must admit no measurable radiation
-if the waist is held for 10 half-lives and radiation is detected from the waste it needs to be held for a longer period until no radiation is detected
Discuss the procedure for the declaration of pregnancy by a radiation worker
-If she declares the pregnancy she must do so in written and include an approximate date of impregnation
-a fetal badge must be issued and worn in the abdominal region to quantify radiation exposure to the fetus
-the fetus exposure must not exceed 500 mrem for the total duration of the pregnancy
describe the type of radiation material used permitted by license code 10 CFR 35.100.
-This allows the use of unsealed byproduct materials for uptake, dilution, and excretion studies in which a written directive is not required
-this code permits the use of radioactive material for laboratory testing in which radioactive materials are injected, inhaled, or ingested and then a bodily fluid such as blood or urine is tested for radionuclide uptake
-does code also requires nuclear medicine facilities to have a survey meter capable of detecting those rates from .1 to 100 mR/hr
Describe the type of radioactive material use permitted by license code 10 CFR 35. 500.
-Permits the use of sealed sources for diagnostic purposes
- sealed sources and devices should have certificates of authorization for diagnostic use on file in the national shield source and device registry
Describe the information that must be included in a written directive
A written directive is needed when administrating any therapeutic dose of radioactive material
-prior to administrating a therapeutic dose of written directive must be obtained and it must contain the following information
• The patients name
• the name, does, and route of administration of the radioactive material
• the purpose for this administration
• the date and time of the administration of radioactive materials •the signature of the authorized user performing or overseeing the administration of radioactive material
Discussed the importance of a quality management program
The purpose of a quality management program is to reduce the risk of administration errors and reportable events
-The five main adjectives essential to any quality management program are •a written directive is obtained prior to administration of any radioactive material
•the patient is verified with more than one method
•all calculations and courses of treatment follow the written directive •the radioactive material is administered according to the written directive appropriate action is taken if deviation from the written directive occurs
List the department records that need to be retained for three years
-All records of department wipe test and surveys
-all dose calibrator eval's such as linearity, constancy, and accuracy
- all records of patient does administrations both diagnostic and therapeutic
-all written directives
- all records of radioactive trash decayed and disposed of
-receipts for all radioactive shipments
Explain how distance from radioactive sources affect ALARA
-Maintaining distance from a radioactive source is one of the most effective and least expensive ways to reduce radiation exposure
-the inverse square law tells us that if the distance from a radioactive source is doubled the radiation exposure is 1/4 of that at the original distance
Discuss the regulations for radiation exposure
-The NRC has established annual radiation exposure limits for humans
public= < 100 mRem/year
RAD workers= <5,000 mRem/year
pregnant= < 500 mRem/ 9 months
eye= < 15,000 mRem/year
skin= < 50,000 mRem/year
Explain the significance of relative biologic effectiveness (RBE)
-Relative biologic effectiveness refers to the fact that different types of radiation produce different biologic effects
-RBE primarily is the ratio of and absorb those of x-rays or gamma rays to the amount of any other form of radiation that is needed to produce the same biologic affect
RBE= Dose of x -ray or gamma radiation/ Equivalent dose of radiation in question
Define deterministic effects of radiation
results that can happen to the body in the result of being exposed to different levels of radiation
-can also be referred to as non-stochastic radiation effects
-deterministic effects are a result of a high dose of radiation over a short period of time
-the grater the amount of radiation exposure the more severe the biological affect affects convey from redness of the skin to death in some cases
-determine mystic events can be immediate as with very high levels of radiation or may take a few days to develop as my occur with relatively low levels of radiation
Define stochastic effects of radiation
Stochastic effects of radiation or generally associated with exposure of low level radiation over a prolonged period of time
-Long term exposure to low-level radiation can lead to leukemia in other forms of cancer
-Long term low level radiation exposure has been associated with genetic birth defects but is it extremely difficult to determine what percentage of those are related to radiation exposure
Discussed the difference between direct and indirect action regarding cellular effects of radiation
-Direct action refers to cellular damage in response to direct absorption of ionizing radiation
-this type of ionization occurs at all levels of radiation
-The greater the exposure to radiation the greater the amount of cellular damage
-indirect action refers to the production of a free radical as a result of radiation exposure
-a free radical is an electrically neutral atom with an unoccupied electron
Discuss the purpose of the radiation safety committee RSC
-The radiation safety committee is responsible for the safe use of radiation and radioactive materials
-the committee must consist of a radiation safety officer a, member of the facilities administration, an authorized user, any member of each department in which radioactive materials are used
List of department records that need to be retained for five years
-all records of radioactive materials transferred from one facility to another department, inventory of all sealed forces including flood sources ,radioactive markers and attenuation correction sources, all leak test that have been performed on the inventory of sealed source, records of all administration errors
Explain the significance of a bioassay
-A bioassay should be performed on all radiation workers involved in I 131 therapeutic procedure
-this ensures that the thyroid is not being overexposed to I 131
-these results need to be retained indefinitely
-if a radiation worker has absorbed more than 3 µCi of I 131 in a year the workers should be relieved of isotope handling duties for the remainder of the year
Discuss Alpha decay
Alpha decay is the process in which the unstable Adam emits an alpha particle in order to achieve stability
-alpha particles have an atomic structure identical to a helium atom 2 protons 2 neutrons
-Alpha decay typically occurs in heavier atoms such as uranium 238 and the daughter Atom is lighter than the parent atom by the amount of helium Atom
Discuss the proper labeling of radioactive packages
White 1 label
surface radiation level less than .5 mR/hr and a 0 Transportation index

yellow 2
surface radiation level greater than .5 mR/hr but less than 50 mR/hr and a transportation index greater than 0 but less than 1.0 at 1 meter

yellow 3
surface radiation level greater than 50 mR/hr but less than 200 mR/hr and a transportation index greater than 1 but less than 10 at 1 meter
List the department records that need to be retained indefinitely
-all records of personal radiation exposure
- all minutes from radiation safety committee meetings
-does calibrator geometry valuations
-all records of by 131 bioassays Free performed on radiation workers
Discuss the role of the radiation safety officer RSO
-The RSO is responsible for the safe use of radiation and radioactive materials
-the RSO is also responsible for recommending or approving correct of actions, identifying radiation safety problems, initiating action, and ensuring compliance with regulations -other duties of the RSO include annual review of the radiation safety program for adherence to ALARA, concepts quarterly review of external and occupational exposure of authorized users and workers to determine that the exposures are ALARA, and quarterly reviews of records of radiation level surveys
- the RSO Reviews radiation levels in unrestricted and restricted areas to determine that they were ALARA during the previous quarter
Define radioactive decay
-Radioactive decay is the manner in which an unstable atomic nucleus loses energy by producing ionizing particles in an effort to become stable -the original unstable Atom is known as the parent and the Atom it decays into is known as a daughter
-if the daughter Atom is stable the radioactive decay process is complete -if the daughter Atom is unstable the radio active decay process continues until stable atom is achieved
Define radiation brachytherapy
-This is a type of radiation therapy in which the radioactive source is surgically implanted into a patient -Brachytherapy is also referred to as internal radiotherapy, sealed source radiotherapy, endocurietherapy, or Curietherapy.
-Bachytherapy is commonly used for the treatment of prostate, breast, cervical, and skin cancers.
- it can be performed alone or in conjunction with other therapeutic form such as chemotherapy
Discuss the types of signs that are posted to one of radioactivity
-Caution radioactive materials Signs are posted 30 CM from the radiation source is sufficient for areas with the radiation level below 5 mR/hr
-caution radiation area must be posted 30 CM from the radiation source of radioactive surface in all areas I have a radiation level greater than 5 mR/hr
-caution high radiation area sign is required in all areas in which the radiation level exceeds 100
Explain the occupational radiation exposure limits established by the NRC
Total dose for the year= < 5 rem
Total organ dose= < 50 rem
eye=< 15 rem
Extremity= < 50 rem
minors= 10 % dose of adults
Discuss the types of signs that are posted to warn of radioactivity
- Caution radioactive materials= < 5 mR/hr
-Caution radiation area = > 5 mR/hr
-Caution High radiation area = > 100 mR/hr
Post signs 30 cm from radiation source
Describe the type of radioactive material use permitted by license code 10 CFR 35.300
-allows the sue of unsealed byproduct material that is prepared for medical purposes and required written directive.
-this code governs all radioactive materials that are administered for therapeutic purposes, such as I-131, Sm-153, and Y-90.
It states that the radioactive material must be obtained from a licensed manufacturer prepared by a nuclear pharmacist and administered by an authorized user or individual supervised by an authorized user.
Describe the type of radioactive material use permitted by license code 10 CFR 35.400
Allows the use of radioactive material for brachytheraputic purposes.
-Isotopes covered under this code are
*Cs-137 for topical, interstitial, or intracavitary treatment.
*Co-60 for topical, interstitial, or intracavitary treatment
*Gold (Au-198) seeds for interstitial treatment
*Ir-192 for interstitial treatment
*Sr-90 eye applicators
*I-125 seeds for interstitial treatment
* Pd-103 seeds for interstitial treatment
Describe the type of radioactive material use permitted by license code 10 CFR 35.600
-Permits the use of a seal source in a remote afterloader unit, teletherapy unit, or gamma stereotactic readiosurgery unit.
-Regulates the use of Co-60 and Cs-137 in teletherapy unit.
-Governs isotopes used for research in accordance with an active Investigational Device Exemption (IDE) accepted by the FDA
Describe the type of radioactive material use permitted by license code 10 CFR 35.200
-Allows the use of unsealed byproduct material for imaging and localization studies in which a written directive is not required.
-Governs imaging procedures that require a photon emitter with energy sufficient to be imaged, primarily with a gamma camera.
-Although the use of Tc-99m for imaging studies is the primary focus of code 10 CFR 35.200, this code governs all other isotopes used in nuclear medicine, such as I-131 and Tl-201
Discuss the role of Metastron (SR-89) in clinical nuclear medicine.
-Metastron is radioactive, beta emitting Sr-89 used to treat the pain associated with widespread metastatic lesions in the bone.
-Metastron is administered through slow IV injection with an activity of 4 mCi.
-Metastron therapy does not instantly relieve the pain but may take up to 7 days to do so.
-If additional doses of Metastron are required, 90 days should elapse between doses.
Discuss the ICANL and its significance in nuclear medicine facilities.
- Is an accrediting body that imposes standards for nuclear cardiology, nuclear medicine, and PET facilities that must be met for accreditation.
-many insurance reimbursements are based on procedures being preformed at accredited facilities.
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